Category: Oncotarget

Comprehensive Genomic Profiling in Cancer: Insights from Over 10,000 Tumors

December 15, 2025

“The OncoExTra^® assay (formerly GEM ExTra) is a whole exome, whole transcriptome, tumor-normal genomic profiling assay that is designed to identify somatic (tumor-specific) SNVs, CNAs, indels, gene fusions, and alternative transcripts.“

Cancer treatment is moving toward a more precision-based approach, where therapies are guided not just by the tumor’s location but also by its genetic features. Mutations in cancer cells can point to specific drugs that may be more effective for certain patients. However, detecting these mutations often requires broad and detailed analysis. This is where comprehensive genomic profiling becomes especially important.

One of the main challenges in cancer care is that many existing genetic tools focus on only a limited number of mutations. As a result, some treatment opportunities may be missed. Certain mutations are also difficult to detect because they occur at low levels or exist in complex forms, such as gene fusions. Without advanced screening methods, these changes may go unnoticed.

To address these challenges, researchers from Exact Sciences Corporation conducted a large-scale study using a broad genomic screening approach. The findings were recently published in the journal Oncotarget.

The Study: Using OncoExTra to Analyze Genetic Alterations in Advanced Solid Tumors

In this study, titled “Comprehensive genomic profiling of over 10,000 advanced solid tumors” and led by Jean-Paul De La from Exact Sciences Corporation, researchers used a method called OncoExTra to analyze over 11,000 tumor samples from more than 10,000 patients with advanced solid tumors. The goal was to understand how often genetic alterations that could guide treatment were found using this type of broad assay.

The Results: Actionable Mutations Found in Over 90% of Tumors

The study found that nearly 92 percent of the tumor samples contained at least one genetic alteration that could potentially guide treatment. About half of the samples had mutations that were linked to therapies already approved by the U.S. Food and Drug Administration, either for the cancer type being studied or for other types.

Some of these mutations were found at very low levels, which highlights the need for sensitive screening techniques. Gene fusions, alterations that can be difficult to detect with standard methods, were identified in 7.5 percent of the cases. These fusions are especially relevant in certain cancers like prostate cancer and sarcoma, where they can influence treatment and, in some cases, help clarify the diagnosis.

Mutations were also found in several key biological pathways that are involved in how cancer cells grow, divide, and repair themselves. These included the PI3K/AKT, MAPK, and DNA repair pathways. Changes in these pathways can affect how the cancer behaves and responds to treatment.

In addition, the study reported that about 8 percent of the samples had mutations in the promoter region of the TERT gene. These changes have been associated with increased tumor growth and worse patient outcomes in several cancers. Although there are no approved therapies that directly target these mutations yet, their detection may become more relevant as new treatments are developed.

The Breakthrough: A Genomic Method That Analyzes Both DNA and RNA

The OncoExTra assay stands out for its ability to analyze both DNA and RNA across all known genes. It also compares tumor tissue to the patient’s normal tissue, which helps reduce the risk of false-positive results. This broad and in-depth approach enables the detection of rare, low-level, and complex mutations that smaller screening panels might miss. The method also identifies biomarkers such as tumor mutational burden and microsatellite instability, which can help determine whether a patient is likely to benefit from certain types of immunotherapy.

The Impact: Improving Precision Oncology Through Genetic Insights

These findings suggest that comprehensive genomic profiling can provide valuable information to help guide treatment for patients with advanced cancer. By identifying relevant mutations, clinicians can make more informed decisions, whether that involves prescribing targeted therapies, recommending clinical trials, or confirming a diagnosis. This supports a more individualized approach to cancer care, aiming to match each patient with the most appropriate treatment options based on the biology of their tumor.

Future Perspectives and Conclusion

While further studies are needed to better associate genomic findings with patient outcomes, this research demonstrates the clinical value of comprehensive genomic profiling. As screening methods continue to improve and become more widely available, they may enable more patients to receive treatments guided by the biological features of their tumors rather than tumor location alone.

Overall, the study shows that large-scale genomic screening is both feasible and useful in real-world oncology practice. It supports a more precise and informed approach to cancer care, while underscoring the importance of continued research and careful integration of genomic tools into clinical decision-making.

Click here to read the full research paper published by Oncotarget.

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Oncotarget is an open-access, peer-reviewed journal that has published primarily oncology-focused research papers since 2010. These papers are available to readers (at no cost and free of subscription barriers) in a continuous publishing format at Oncotarget.com.

Oncotarget is indexed and archived by PubMed/Medline, PubMed Central, Scopus, EMBASE, META (Chan Zuckerberg Initiative) (2018-2022), and Dimensions (Digital Science).

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Oncotarget

Repurposing Statins: Exploring Anti-Tumor Effects in Colorectal Cancer

December 3, 2025

“Drug repurposing has gained traction as a viable strategy to target dysregulated oncogenic pathways.“

Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths globally. While early detection significantly improves outcomes, many patients are diagnosed at advanced stages when treatment options are limited and relapse is common. To address this challenge, researchers are exploring whether existing drugs can be repurposed for cancer therapy, a strategy that could accelerate drug development while reducing associated costs and risks.

One class of drugs under investigation is statins, commonly prescribed to reduce cholesterol and prevent cardiovascular disease. Several studies have observed a potential link between elevated cholesterol and increased CRC risk. Cholesterol may support tumor growth by promoting membrane synthesis and energy metabolism in rapidly dividing cells.

Building on this connection, researchers from leading Indian institutions, including the Indian Institute of Science Education and Research and the Center of Excellence in Epigenetics at Shiv Nadar Institution of Eminence, investigated how statins influence CRC cells at the molecular level. Their goal was to determine whether these widely used drugs could have a therapeutic role in oncology.

The Study: Investigating the Molecular Impact of Statins in CRC Cells

The study, titled “Statins exhibit anti-tumor potential by modulating Wnt/β-catenin signaling in colorectal cancer,” was published in Oncotarget (Volume 16). Using a combination of lipidomics, transcriptomics, proteomics, and 3D tumor models, the researchers explored how two widely prescribed statins, atorvastatin and simvastatin, affect molecular pathways associated with CRC progression. This integrative, multi-omics strategy enabled tracing statin-induced effects across different layers of cellular function, linking lipid, transcript, and protein changes to pathway-level shifts.

The Results: Statins Suppress Wnt/β‑Catenin Signaling and Alter SATB Protein Dynamics

Treatment of CRC cells with statins led to a significant reduction in cholesterol and related lipid metabolites, consistent with the drugs’ known mechanism of action. Importantly, statin exposure also suppressed the Wnt/β-catenin signaling pathway, a key regulator of cell proliferation and tumor growth in CRC.

At the protein level, the researchers observed a decrease in SATB1, a chromatin organizer associated with oncogenic gene expression and tumor aggressiveness. At the same time, SATB2, a structurally related protein with tumor-suppressive properties, was upregulated. This inverse regulation appears to shift cancer cells from a more invasive, mesenchymal-like phenotype toward a more stable, epithelial state.

Interestingly, the levels of SATB1 and SATB2 mRNA did not change significantly, suggesting that statins affect these proteins post-transcriptionally, possibly by altering their stability. This layer of regulation may offer a more targeted and potentially safer therapeutic strategy.

The functional impact of statin treatment was further evaluated in 3D spheroid models, which better replicate the architecture of solid tumors. In these models, statins disrupted spheroid integrity and promoted the reappearance of cellular features typically associated with non-malignant epithelial tissue. SATB1 expression correlated with mesenchymal traits, while SATB2 was linked to epithelial markers, reinforcing their proposed roles in tumor phenotype regulation.

These findings were corroborated in in vivo xenograft models, where mice treated with statins exhibited significantly reduced tumor volumes compared to untreated controls. This in vivo validation supports the therapeutic potential of statins in suppressing tumor growth under physiological conditions.

The Impact: Potential Clinical Applications of Statins in Oncology

Since statins are already approved and well tolerated in humans, their potential use in oncology may benefit from an accelerated translational path. These findings suggest statins could be particularly useful in early-stage CRC or in combination with other therapies to reduce tumor growth and recurrence. By modulating a fundamental cancer-related pathway without broadly disrupting healthy cells, statins may offer a more selective and tolerable therapeutic option.

Future Perspectives and Conclusion

While the study results are encouraging, further preclinical investigations and clinical trials will be necessary to confirm the anti-tumor effects of statins in human patients. The authors note that treatment efficacy may be different depending on tumor subtype and underlying molecular characteristics. Nonetheless, the research provides strong evidence that the balance between SATB1 and SATB2 plays a critical role in CRC progression and that statin treatment can shift this balance in a therapeutically favorable direction.

Moreover, since pathways such as Wnt signaling and SATB1 regulation are implicated in several other malignancies, the findings may have relevance beyond CRC and be worth investigating in additional tumor types. This study adds to the expanding body of research supporting drug repurposing as a viable strategy in cancer therapy.

Click here to read the full research paper published by Oncotarget.

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Oncotarget

New Antibody Removes Tregs to Boost Immune Response Against Cancer

November 19, 2025

“Treg play a deleterious role in the tumor microenvironment by suppressing anti-tumor effector T cells.”

Cancer is a disease caused by the uncontrolled growth of cells that escape the body’s natural defenses. One way cancer protects itself is by taking advantage of certain immune cells called regulatory T cells, or Tregs. Normally, Tregs help prevent autoimmune diseases by controlling the immune system. But inside tumors, they behave differently. Instead of defending the body, they suppress the immune cells that could attack the cancer.

Many cancer treatments aim to activate the immune system to fight tumors more effectively. However, the presence of Tregs within the tumor makes this difficult. These cells act like bodyguards for the cancer, blocking the immune response that might otherwise slow or stop tumor growth.

Researchers have tried to eliminate Tregs by targeting a protein called CD25, found on their surface. However, earlier efforts often failed because these treatments also interfere with interleukin-2 (IL-2), a molecule that is essential for other immune cells to function. Blocking IL-2 weakens the entire immune response, limiting the treatment’s effectiveness.

To overcome this challenge, scientists recently developed a new antibody called 2B010. This study, titled “A novel anti-human CD25 mAb with preferential reactivity to activated T regulatory cells depletes them from the tumor microenvironment,” was published in Oncotarget (Volume 16)

The Study: Finding a New Antibody Against Tumor Tregs

To develop a more selective tool for targeting Tregs, researchers from the National Institute of Allergy and Infectious Diseases, in collaboration with Boehringer Ingelheim and led by Maja Buszko and Ethan M. Shevach, conducted an experiment using mice. The animals were exposed to human regulatory T cells that had been activated and expanded in the laboratory. This exposure triggered the mice’s immune systems to produce antibodies against the Tregs. Among the resulting hybridomas, one named 2B010 stood out for producing an antibody capable of binding to CD25, a protein commonly found on the surface of active Tregs.

The Results: 2B010 Shows Selective Treg Depletion and Immune Activation

The 2B010 antibody was effective in both cell-based and animal studies. It was able to detect and remove regulatory T cells that were actively protecting tumors, without disrupting IL-2 signaling. This allowed the rest of the immune system to stay functional.

In a mouse model of human breast cancer, treatment with 2B010 significantly reduced the number of Tregs inside the tumors. As a result, CD8+ T cells, which are responsible for killing cancer cells, became more active. While the tumors themselves did not shrink, the immune system clearly showed signs of stronger activity against the cancer.

What makes 2B010 different is its ability to distinguish between harmful and helpful immune cells. Although many immune cells express CD25 when activated, 2B010 preferentially binds to highly active Tregs within the tumor. This selectivity allows it to target only the cells that shield tumors, while sparing other important parts of the immune system.

The effect of 2B010 was not limited to the tumor site. Increased immune activity was also observed in the spleen, suggesting that this antibody may help support the body’s general immune response.

The Impact: Potential Role of 2B010 in Enhancing Cancer Immunotherapy

This discovery offers a potential direction for advancing cancer treatment. By removing the regulatory T cells that shield tumors from immune attack, the 2B010 antibody could improve the effectiveness of current immunotherapies. It may be particularly valuable when used alongside checkpoint inhibitors, drugs that help lift the immune system’s natural brakes. Together, these therapies could produce a stronger, more sustained anti-tumor response.

Since high levels of Tregs are linked to poor outcomes in many types of cancer, selectively eliminating these cells may help overcome a major obstacle in immunotherapy. In addition, because 2B010 does not interfere with IL-2 signaling, it may avoid the unintended side effects seen with earlier anti-CD25 antibodies. Together, these features make it a good candidate for more precise and better-tolerated cancer treatments.

Future Perspectives and Conclusion

While the 2B010 antibody shows strong potential in preclinical studies, its performance in human patients remains to be seen. Clinical trials will be essential to assess its safety, effectiveness, and compatibility with current cancer treatments. Researchers suggest that, with further development, 2B010 may become a valuable addition to combination immunotherapy strategies in the future.

Click here to read the full research paper published by Oncotarget.

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Oncotarget

How Low Oxygen Shields Prostate Cancer from Ferroptosis Therapies

November 6, 2025

“Preclinical and clinical studies indicate that ferroptosis suppresses tumor growth, and dysregulation of ferroptosis promotes treatment resistance in cancer.”

Prostate cancer is one of the most common cancers in men. While treatment options have improved, advanced stages of the disease remain difficult to manage. One promising approach involves a process called ferroptosis. This is a type of programmed cell death that relies on iron and lipid oxidation to kill cancer cells by damaging specific fats in their outer membrane. These fats are especially vulnerable in environments with normal oxygen levels.

However, many prostate tumors grow in low-oxygen areas of the body, a condition known as hypoxia, where ferroptosis becomes less effective. A recent study, titled “Hypoxia induced lipid droplet accumulation promotes resistance to ferroptosis in prostate cancer,” and published on Oncotarget (Volume 16), explores how oxygen-poor environments help prostate cancer cells resist treatment and what strategies could help overcome this resistance.

The Study: How Low Oxygen Helps Prostate Cancer Resist Ferroptosis Treatments

A research team from the University of Arizona, led by Dr. Noel Warfel and Dr. Shailender Chauhan, studied how prostate cancer cells respond to ferroptosis-inducing drugs when oxygen levels are low. Their goal was to understand what changes happen inside cancer cells that help them survive under these conditions.

The Results: Prostate Cancer Cells Store Fats to Survive Ferroptosis in Low Oxygen Conditions

The researchers found that prostate cancer cells exposed to low-oxygen conditions were much less sensitive to ferroptosis-inducing drugs such as Erastin and RSL3. Even when the two drugs were combined to boost their effect, the cancer cells remained resistant.

Under hypoxia, the cancer cells changed how they processed fats. They produced fewer of the fragile fats that are typically targeted by ferroptosis and instead created more stable fats, which were stored in small compartments called lipid droplets. These droplets acted like protective storage units, shielding the vulnerable fats from oxidative damage.

The study also showed that hypoxia reduced the activity of genes like ACSL4 and LPCAT3, which help incorporate polyunsaturated fatty acids into cell membranes, fats that are crucial for making cells susceptible to ferroptosis. At the same time, the levels of oxidation-prone fats like phosphatidylethanolamines decreased, while more stable lipids such as cholesteryl esters and triglycerides increased.

The researchers attempted to block lipid droplet formation, but the results varied depending on the cell type, suggesting that other factors may also contribute to this resistance.

The Impact: Targeting Fat Storage May Improve Prostate Cancer Treatment

This study highlights the critical role of the tumor microenvironment, especially oxygen levels, in shaping how cancer cells respond to treatment. It suggests that ferroptosis-inducing drugs alone may not be effective against tumors growing in low-oxygen conditions.

To overcome this resistance, future therapies could include inhibitors that block the enzymes or pathways responsible for lipid droplet formation, making cancer cells more vulnerable to ferroptosis.

Future Perspectives and Conclusion

This study provides valuable insight into how prostate tumors resist ferroptosis-based therapies and points to new treatment strategies. Targeting how cancer cells manage and store fats, by preventing the buildup of lipid droplets or releasing stored fats, may help restore their sensitivity to ferroptosis. While more research is needed to fully understand this mechanism, the findings mark a step toward more effective cancer treatments. This approach could also be applied to other solid tumors that show similar resistance in low-oxygen environments.

Click here to read the full research paper published by Oncotarget.

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Genetic Study Identifies Potential Diagnostic Marker for Rare Blood Cancer BPDCN

October 22, 2025

“Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy with poorly characterized molecular features.”

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare blood cancer that primarily affects older adults. One of the key challenges in diagnosing and treating BPDCN is that it closely resembles other forms of leukemia in both appearance and behavior. This overlap often leads to delays or uncertainty in diagnosis, especially since currently there is no single, reliable marker that clearly distinguishes BPDCN from related diseases.

To address this issue, researchers from the City of Hope Comprehensive Cancer Center investigated the genetic profile of BPDCN. Their study, titled “Genetic characteristics of blastic plasmacytoid dendritic cell neoplasm: A single institution experience,” was published in Oncotarget (Volume 16).

Understanding BPDCN: A Rare and Aggressive Blood Cancer

BPDCN is an aggressive cancer that commonly affects the skin, bone marrow, and lymph nodes. Diagnosing it remains difficult due to its overlap with other blood cancers. Although targeted therapies and stem cell transplantation have led to some progress, overall outcomes remain poor. Most patients survive only one to two years after diagnosis, emphasizing the need for earlier detection and more effective treatment options.

The Study: Genetic Sequencing in BPDCN Patients

Led by first author Fei Fei and corresponding author Michelle Afkhami, from the City of Hope Comprehensive Cancer Center, researchers performed targeted DNA and RNA next-generation sequencing (NGS) on samples from 21 patients with BPDCN—nineteen male and two female.

Their goal was to better understand the genetic mutations associated with this disease and evaluate whether any of these changes could be used to improve diagnosis or predict disease progression.

The Results: Genetic Alterations in BPDCN

The study revealed frequent mutations in genes such as TET2 (57%) and ASXL1 (33%), both of which are involved in regulating DNA activity. These mutations were often associated with shorter survival, particularly when multiple mutations occurred in a single patient. Other mutated genes were NRAS (29%), SRSF2 (14%), ZRSR2 (14%), and KMT2D (14%).

Another important finding was the gene CCDC50, which showed significantly higher expression in BPDCN compared to related cancers like acute myeloid leukemia (AML) and chronic monomyelocytic leukemia (CMML). In patients who responded well to treatment, CCDC50 levels declined, suggesting its potential usefulness in monitoring treatment response.

The Impact: CCDC50 as a Diagnostic Marker

The study highlights CCDC50 as a potential marker for BPDCN. Its high expression in this cancer—and not in related blood malignancies—suggests it could support both diagnosis and monitoring of treatment response. If validated in larger studies, it could become a valuable tool for clinicians seeking earlier and more accurate diagnoses.

Additionally, the association between mutations in genes like TET2 and ASXL1 and patient outcomes may help guide risk assessment and inform more personalized treatment decisions.

Future Perspectives and Conclusion

While these findings offer important insights, the study was based on a relatively small patient group. Further research is needed to confirm the role of CCDC50 and increase the understanding of how genetic mutations affect BPDCN progression. Nonetheless, this study represents a step toward more precise diagnostic tools and tailored treatments for a disease that remains challenging to manage.

Click here to read the full research paper published by Oncotarget.

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Oncotarget

New Insights into HER2-Mutated Non-Small Cell Lung Cancer in Brazil

October 8, 2025

“In non–small cell lung cancer (NSCLC), alterations in the HER2 (ERBB2) gene define a unique molecular subtype.”

Lung cancer remains one of the leading causes of cancer-related deaths worldwide. Although precision medicine has improved outcomes for many patients, certain rare genetic mutations are still poorly understood, particularly in regions with limited access to genomic testing. Such mutations involve the HER2 gene, better known for its role in breast cancer but also implicated in a small subset of lung cancers.

HER2 mutations are found in approximately 2–4% of non-small cell lung cancer (NSCLC) cases and create unique challenges. These tumors can vary significantly in how they appear under a microscope and in how they respond to treatment. Adding to the complexity, most diagnostic and treatment guidelines are based on research from high-income countries, which may not reflect the genetic diversity seen in other parts of the world.

To help close this knowledge gap, researchers in Northeastern Brazil conducted one of the first detailed investigations into HER2-mutated NSCLC in Latin America. Their study, recently published in Volume 16 of Oncotarget, reveals a complex and often overlooked form of the disease, highlighting the need for broader access to targeted therapies in underserved populations.

The Study: HER2-Mutated NSCLC in Northeastern Brazil

In the study titled “Molecular landscape of HER2-mutated non-small cell lung cancer in Northeastern Brazil: Clinical, histopathological, and genomic insights,” researchers led by first authors Cleto Dantas Nogueira from the Federal University of Ceará and Argos Pathology Laboratory and Samuel Frota from Argos Pathology Laboratory, along with corresponding author Fabio Tavora from the previously mentioned institutions and Messejana Heart and Lung Hospital, analyzed 13 cases of HER2-mutated NSCLC. They used clinical, pathological, and genomic data.

The Results: A Complex Clinical and Molecular Landscape

The analyzed patients ranged in age from 34 to 82 years. More than half were women. About half had never smoked.

The research team discovered different HER2-related mutations. Most tumors carried the well-known A775_G776insYVMA insertion in exon 20 of the HER2 gene. However, rarer mutations such as V842I and Q709L were also identified, indicating substantial genetic diversity. More than half of the patients had additional mutations in other key cancer-related genes, especially TP53, a gene associated with aggressive tumor behavior and resistance to treatment.

Interestingly, most tumors did not overexpress the HER2 protein, even though they carried HER2 mutations. Only one patient showed strong protein expression based on standard immunohistochemistry (IHC) testing. This finding suggests that relying only on protein-level tests may miss cases that could benefit from targeted treatment. Additionally, all tumors had a low tumor mutation burden (TMB), which has been linked to limited effectiveness of immunotherapies.

Treatment access emerged as a major concern. Only one patient received trastuzumab deruxtecan, a promising new drug specifically designed for HER2-mutated cancers. Most were treated with surgery, chemotherapy, immunotherapy, or a combination of these approaches. While a few patients lived for years after diagnosis, most experienced rapid disease progression, especially those diagnosed at more advanced stages.

The Breakthrough: Mutations in Underserved Populations

This study underscores the molecular diversity of HER2-mutated NSCLC and highlights the importance of using comprehensive genetic testing, not just protein-level tests, to detect targetable mutations. It also shows that patients in underserved regions can harbor complex cancers that need personalized treatment approaches.

The Impact: Making the Case for Genomic Equity in Lung Cancer

This research has the potential to reshape NSCLC diagnosis and treatment strategies in Brazil and other low- to middle-income countries. By confirming that HER2 mutations are present in regions where they are rarely investigated, it strengthens the case for expanding access to next-generation sequencing and innovative targeted therapies like trastuzumab deruxtecan.

Future Perspectives and Conclusion

Although the study’s sample size was small, its implications are important. HER2-mutated NSCLC is more genetically diverse than previously recognized, and this variability must be reflected in both diagnostic and treatment strategies. The authors advocate for the establishment of regional molecular tumor boards to guide personalized care and increase access to clinical trials.

As more data becomes available, the goal is to tailor therapies not just to specific mutations but also to the unique characteristics of local patient populations, marking a crucial step toward more equitable cancer care worldwide.

Click here to read the full research paper published by Oncotarget.

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Oncotarget

Precision Oncology in Metastatic Colorectal Cancer: A Real-World Case Study

September 24, 2025

“Heavily pretreated metastatic colorectal cancer (mCRC) poses significant therapeutic challenges.”

Colorectal cancer is one of the most common—and deadliest—cancers worldwide. Once it spreads and reaches the metastatic stage, treatment becomes far more difficult. Tumors can also behave very differently from one patient to another, especially after multiple rounds of therapy. Precision oncology is helping to overcome these challenges by enabling clinicians to analyze each tumor’s unique genetic profile and tailor treatment accordingly.

This approach was recently highlighted in a case study published in Volume 16 of Oncotarget. The report detailed how a 62-year-old man with advanced colorectal cancer received a highly personalized treatment plan, developed by an international panel of experts, after completing all standard treatment options.

The Case: Personalized Cancer Care in Action

Titled “Case Report WIN-MTB-2023001: WIN International Molecular Tumor Board – A 62-year-old male with metastatic colorectal cancer with 5 prior lines of treatment,” the paper illustrates how precision medicine can be applied in real-world cancer care. The paper was led by Alberto Hernando-Calvo from Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology; Razelle Kurzrock from WIN Consortium and Medical College of Wisconsin; Oncotarget Editor-in-Chief Wafik S. El-Deiry from WIN Consortium and Legorreta Cancer Center at Brown University; and corresponding author Shai Magidi, also from WIN Consortium.

The patient had already undergone five different treatment regimens, including chemotherapy and targeted therapies. While some approaches initially showed results, the cancer repeatedly returned. With standard options exhausted, his case was submitted to the WIN International Molecular Tumor Board (MTB)—a global network of cancer experts representing 13 countries.

Comprehensive tumor genetic profiling revealed mutations in key genes such as BRAF, MET, APC, TP53, and NRAS. These alterations are known to promote tumor growth, contribute to treatment resistance, and predict a poor prognosis. Based on these findings, the MTB proposed a series of personalized treatment strategies, using off-label drug combinations designed to target the tumor’s specific genetic vulnerabilities.

Results: A Multi-Drug Treatment Approach

The team proposed several personalized treatment options. One strategy combined amivantamab (a dual-action antibody against MET and EGFR), trametinib (a MEK inhibitor), and regorafenib (a multi-target drug with effects on VEGF and WNT pathways). These combinations were not standard but were based on previous responses and the patient’s mutational profile. The plan was to start with reduced doses to avoid side effects, a method supported by earlier studies. Though access to some drugs was uncertain outside the United States, the goal was to attack the tumor from multiple angles based on its unique weaknesses.

The Breakthrough: Rethinking Cancer Therapy with Precision Oncology

This case highlights a key innovation in cancer treatment—not a new drug, but a new way of thinking. Instead of relying on a one-size-fits-all approach, clinicians matched the therapy to the patient’s tumor genetic characteristics. Importantly, these decisions were developed collaboratively and in real time by an international panel of experts.

The Impact: Expanding Options for Patients with Advanced Tumors

If applied more broadly, this personalized strategy could improve outcomes for patients with hard-to-treat cancers. Especially for those who have failed standard treatments, precision oncology can offer a way forward when no other effective options remain. It is a shift from treating cancer generally to treating the individual behind the diagnosis.

Future Perspectives and Conclusion

Although the patient in this case ultimately passed away, his case shows how much progress has been made in precision medicine. With detailed genetic testing and input from experts around the world, it is now possible to create treatment plans that would have been unthinkable just a few years ago. This case highlights the urgent need for wider access to advanced testing and new treatments, especially in countries where some drugs may not be available. Precision medicine is no longer just an idea for the future; it has become a present-day necessity in complex cancer care.

Click here to read the full Precision Oncology in Oncotarget.

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Immunotherapy Response in Pancreatic Cancer: What a New Study Reveals

September 11, 2025

“Identification and analyses of exceptional responders could eventually offer hints as to why PC is resistant to immunotherapy.”

Immunotherapy is not usually effective against pancreatic cancer (PC), but a new study published in Oncotarget (Volume 16, 2025) highlights rare cases where it did help. These examples, though uncommon, may offer valuable insights for future treatment.

Pancreatic Cancer and Immunotherapy

Pancreatic cancer is often diagnosed at an advanced stage, which limits treatment options and contributes to its poor prognosis. While chemotherapy remains the standard treatment, it usually offers only modest benefits in terms of survival. Immunotherapy—an approach that activates the immune system to fight cancer—has been effective in other cancers but has shown limited success in PC.

This is largely due to the tumor’s ability to suppress immune responses and create an environment that protects it from attack. Currently, these drugs are only approved for a small subset of patients whose tumors have a specific genetic feature called high microsatellite instability (MSI-high), found in just 1 to 2 percent of cases.

The Study: Pancreatic Cancer Immunotherapy Responders

The study, titled “Exceptional responders to immunotherapy in pancreatic cancer: A multi-institutional case series of a rare occurrence,” was led by first author Kavin Sugumar and corresponding author Jordan M. Winter, from University Hospitals Seidman Cancer Center.

The researchers examined medical records from 14 patients with pancreatic ductal adenocarcinoma (PDAC) who had responded unexpectedly well to immune checkpoint inhibitors—drugs that help reactivate immune cells to attack cancer. The drugs included PD-1 inhibitors such as pembrolizumab and nivolumab, CTLA-4 inhibitors like ipilimumab, and agents targeting tumor-associated macrophages. To find these rare cases, the research team contacted 471 oncologists from 91 major U.S. cancer centers between 2020 and 2021.

Most of the patients in this study had already tried chemotherapy, without lasting success. These patients received immunotherapy alone. They were selected because they showed either a reduction in tumor size on imaging or a drop in CA 19-9, a blood marker used to monitor PC.

This case series is the largest to focus exclusively on PC patients who responded well to immunotherapy. By excluding those who received chemotherapy simultaneously, the study aimed to isolate the effects of immune-based treatments alone.

The Results: Immunotherapy Shows Effectiveness in Both MSI-High and MSI-Stable Pancreatic Cancer

After starting immunotherapy, 82% of the patients showed a partial response, meaning their tumors became smaller. Around one-third of the patients had a meaningful decrease in CA 19-9 levels. On average, their disease remained stable for about 12 months, which is longer than typically seen with other treatments at this stage. Some patients lived for more than two years after beginning immunotherapy.

What stood out most was that more than half of these patients did not have MSI-high tumors. This challenges the current understanding that only MSI-high patients are likely to benefit from immunotherapy and suggests that other, less well-understood factors may also play a role.

The Impact: Expanding the Role of Immunotherapy in Pancreatic Cancer

Although this study includes only a small number of patients, the results suggest that immunotherapy may benefit more individuals with PC than previously assumed. While the standard of care still centers on chemotherapy, this case series shows that a small but meaningful group of patients—some without the usual MSI-high genetic marker—can respond well to immune-based treatments. These observations support the idea that immunotherapy may have a broader role in PC care.

Future Perspectives and Conclusion

These findings highlight the need to understand why certain PC patients respond to immunotherapy despite lacking known predictive markers like MSI-high. Exploring tumor biology, immune interactions, and patient-specific characteristics may help identify new indicators of response.

Although immunotherapy remains ineffective for most PC cases, rare outcomes like those in this study offer valuable clues. Investigating these exceptions more closely could support the development of more personalized and effective treatment approaches.

Click here to read the full research paper in Oncotarget.

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Amivantamab Monotherapy in Rare EGFR-Mutated Advanced NSCLC

August 26, 2025

“Amivantamab, an anti-EGFR/MET bispecific antibody, shows efficacy in EGFR-mutated NSCLC, but its role in rare EGFR alterations and CNS involvement, including leptomeningeal disease (LMD), remains insufficiently characterized.“

Non-small cell lung cancer (NSCLC) remains a leading cause of cancer-related mortality. While the development of targeted therapies has improved outcomes for many patients with EGFR-mutated NSCLC, those with rare EGFR variants often face limited treatment options, especially when the disease involves the central nervous system (CNS).

A recent research paper, titled “Durable complete response in leptomeningeal disease of EGFR mutated non-small cell lung cancer to amivantamab, an EGFR-MET receptor bispecific antibody, after progressing on osimertinib” published in Volume 16 of Oncotarget, describes a patient with NSCLC harboring two uncommon EGFR mutations—G719A and A289V—who experienced a prolonged and clinically significant response to amivantamab monotherapy, after prior treatments had failed.

Rare EGFR Mutations and Leptomeningeal Spread

EGFR mutations are present in a subset of NSCLC cases, with most data and drug approvals focused on common variants such as exon 19 deletions and L858R. Mutations like G719A and A289V are far less common and have limited clinical evidence to guide treatment.

The presence of leptomeningeal disease (LMD)—a late-stage manifestation involving the membranes surrounding the brain and spinal cord—further complicates treatment, given the difficulty many therapies face in crossing the blood-brain barrier.

Case Overview: Advanced NSCLC with Leptomeningeal Disease

This case, reported by Jinah Kim from the University of Vermont Medical Center, Young Kwang Chae from Feinberg School of Medicine and colleagues, involved a 67-year-old man with stage IV NSCLC and no history of smoking. Genetic testing identified the presence of EGFR G719A and A289V mutations. Initial therapy with osimertinib, followed by chemotherapy and immunotherapy, failed to control disease progression, which eventually involved both the brain and spinal fluid.

Given his declining performance status, combination therapies were not feasible. As an alternative, clinicians initiated amivantamab monotherapy, a bispecific antibody targeting EGFR and MET receptors. While amivantamab is currently approved in combination regimens, its activity as a single agent in rare EGFR mutations and CNS disease is not well established.

The Results: Response to Amivantamab

Within six weeks of starting amivantamab treatment, imaging showed a 32% reduction in lung tumor size. By six months, Magnetic resonance imaging confirmed complete resolution of brain metastases and LMD. In parallel, blood tests showed a molecular response. Circulating tumor DNA carrying the EGFR mutations dropped from detectable levels to undetectable. The patient, previously wheelchair-bound, recovered the ability to walk and manage activities of daily living. As of the latest follow-up, 19 months into treatment, the disease remained stable, with no signs of recurrence in either the lungs or CNS.

The Breakthrough: Monotherapy in Rare EGFR-Mutated NSCLC

This case challenges several prevailing views in the treatment of EGFR-mutated NSCLC. Amivantamab demonstrated activity against two rare mutations—G719A and A289V—that are poorly characterized and lack established treatment protocols.

The drug was administered as monotherapy, which diverges from current standard use involving combination regimens. Most notably, the clinical response included resolution of CNS involvement, suggesting that amivantamab may possess a degree of blood-brain barrier penetration not typically expected of large antibody-based therapies.

The Impact: A Potential Strategy for Patients with Limited Options

This case shows that amivantamab might be effective in more patients than previously thought, including those with rare mutations and brain metastases. It also raises the possibility of using the drug alone in patients who cannot tolerate combination therapies. These findings are especially significant because current clinical trials often exclude patients with untreated brain metastases, leaving a gap in NSCLC care.

Future Perspectives and Conclusion

This case provides a detailed example of amivantamab monotherapy being associated with sustained disease control in a patient with advanced NSCLC, rare EGFR mutations, and leptomeningeal involvement. Although it reflects a single patient’s experience, the outcome raises important questions for further research.

Key areas for investigation include the mechanism by which amivantamab may cross the blood-brain barrier—a longstanding challenge in treating CNS metastases. Additional studies are also needed to evaluate its efficacy against other rare EGFR mutations and to determine whether monotherapy could be a feasible option for patients who are unable to tolerate standard combination regimens.

While limited in scope, this case underscores the need for broader clinical data and suggests that amivantamab may have a role in complex, treatment-resistant NSCLC presentations.

Click here to read the full research paper in Oncotarget.

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Oncotarget is indexed and archived by PubMed/Medline, PubMed Central, Scopus, EMBASE, META (Chan Zuckerberg Initiative) (2018-2022), and Dimensions (Digital Science).

Click here to subscribe to Oncotarget publication updates.

For media inquiries, please contact media@impactjournals.com.

Oncotarget

Cigarette Smoke and Weak DNA Repair: A Double Hit Behind Lung Cancer Risk

August 11, 2025

“Lung cancer remains the leading cause of cancer-related fatalities in the United States and worldwide, with cigarette smoking the most well-established risk factor for lung cancer.“

Lung cancer, particularly non-small cell lung cancer (NSCLC), is the deadliest cancer worldwide. Cigarette smoking is one of the main causes, but not every smoker develops the disease. This suggests that other biological factors help determine who develops cancer.

Researchers from the Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Indianapolis, and from the Richard L. Roudebush Veterans Affairs Medical Center have now found that cigarette smoke, combined with a weakened DNA repair system, can trigger the early stages of lung cancer, particularly NSCLC. This work, led by first author Nawar Al Nasralla and corresponding author Catherine R. Sears, was recently published in Volume 16 of Oncotarget.

Understanding the Link Between Cigarette Smoke and DNA Repair

NSCLC develops through a mix of genetic and environmental factors, with tobacco smoke as a major driver. Cigarette smoke contains thousands of harmful chemicals, many of which can damage DNA in the cells covering the airways. The body has natural systems to repair DNA damage and keep cells healthy. For example, one key protein, Xeroderma Pigmentosum Group C (XPC), detects specific types of DNA damage and starts the repair process, helping to maintain cellular genetic stability.

When DNA repair does not work properly, damaged DNA can remain in cells. Over time, these alterations may accumulate and lead to uncontrolled cell growth, raising the risk of NSCLC, and other lung diseases, such as chronic obstructive pulmonary disease (COPD).

The Study: Investigating the Relation Between DNA Repair and Lung Cancer Development

In the paper “Cigarette smoke and decreased DNA repair by Xeroderma Pigmentosum Group C use a double hit mechanism for epithelial cell lung carcinogenesis,” the research team investigated how cigarette smoke affects DNA repair when XPC function is reduced and whether this combination accelerates lung disease and cancer development.

They studied both healthy lung cells and lung cancer cells to compare how each type reacted to cigarette smoke exposure. By analyzing these differences, the team aimed to better understand how weakened DNA repair systems might set the stage for NSCLC and other lung diseases.

The Results: XPC Reduction is Part of NSCLC Development

The study found major differences between healthy lung cells and lung cancer cells when DNA repair was compromised. In healthy bronchial cells, cigarette smoke reduced DNA repair ability, increased DNA damage, and caused more cell death. These effects became stronger when XPC levels were lower.

Lung cancer cells responded differently, showing greater resistance to cigarette smoke. They required higher exposure to cause similar DNA damage, and lowering XPC had little effect on their survival, suggesting they rely on other mechanisms to manage the damage.

The researchers also examined genomic instability—signs that DNA is becoming dangerously unstable. In healthy cells, reduced XPC made cigarette smoke damage more likely to produce micronuclei, small DNA fragments that indicate higher cancer risk. In lung cancer cells, lowering XPC did not significantly change these markers.

Finally, in human NSCLC tumor samples, both lung adenocarcinomas and squamous cell carcinomas had much lower XPC levels than nearby healthy tissue. This was true regardless of smoking history, indicating that XPC loss is part of tumor biology rather than simply a result of cigarette smoke.

The Breakthrough: A Double Hit Driving Lung Disease Development

The findings point to a dangerous partnership between cigarette smoke and weakened DNA repair. Cigarette smoke delivers the first hit by directly damaging DNA. Reduced XPC delivers the second hit by limiting the cell’s ability to repair that damage. Together, these effects allow genetic errors to accumulate, increasing the probability that lung cells become cancerous. This “double hit” mechanism may help explain why some smokers develop lung diseases while others do not.

The Impact: Lung Cancer Prevention and Care

Testing for DNA repair capacity, especially XPC levels, could help identify people at higher risk for lung cancer, even before symptoms appear. Such screening could guide targeted prevention strategies for smokers and previous smokers.

Future Perspectives and Conclusion

This research highlights the importance of protecting cells’ DNA repair systems, particularly XPC, to reduce lung cancer risk. The next step will be to understand why XPC levels drop in lung cells. Identifying and addressing the causes could lead to prevention strategies for people exposed to cigarette smoke, including those who have already quit but remain at risk. Preserving or restoring XPC function could be a therapeutic strategy to slow or even prevent the earliest stages of NSCLC caused by cigarette smoke.

Overall, when cigarette smoke and reduced DNA repair act together, they can cause severe damage to lung cells, increase genetic instability, and raise the chances of developing NSCLC.

Click here to read the full research paper in Oncotarget.

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Oncotarget is indexed and archived by PubMed/Medline, PubMed Central, Scopus, EMBASE, META (Chan Zuckerberg Initiative) (2018-2022), and Dimensions (Digital Science).

Click here to subscribe to Oncotarget publication updates.

For media inquiries, please contact media@impactjournals.com.